BACKGROUND: Suicide is the leading cause of death in Korean adolescents and it exposes school teachers to the impact of student suicide.
AIMS: This study aimed to explore the bereavement experience of teachers following student suicide.
METHOD: Using semistructured questions, five female teachers working at secondary schools in Korea were interviewed on their bereavement experiences. Data were analyzed using a phenomenological approach.
RESULTS: Participants described their experiences in dimensions of individuals and professions, yielding four major themes and 11 subthemes. They made efforts to learn about the suicide as a first step toward understanding. Participants suspended their grief in public owing to the atmosphere in their workplace. They aimed to tolerate the suicide and recognized their role anew in preventing student suicide.
CONCLUSION: Following student suicide, bereaved teachers experience a variety of effects, dysfunctions, and adjustments as individuals and professionals. Their experience should be understood in both individual and collective ways in school settings and in the cultural context. The findings encourage school health providers to develop programs and policies to help teachers bereaved by student suicide.
BACKGROUND: The use of advance care planning and advance decisions for psychiatric care is growing. However, there is limited guidance on clinical management when a patient presents with suicidal behaviour and an advance decision and no systematic reviews of the extant literature.
OBJECTIVES: To synthesise existing literature on the management of advance decisions and suicidal behaviour.
DESIGN: A systematic search of seven bibliographic databases was conducted to identify studies relating to advance decisions and suicidal behaviour. Studies on terminal illness or end-of-life care were excluded to focus on the use of advance decisions in the context of suicidal behaviour. A textual synthesis of data was conducted, and themes were identified by using an adapted thematic framework analysis approach.
RESULTS: Overall 634 articles were identified, of which 35 were retained for full text screening. Fifteen relevant articles were identified following screening. Those articles pertained to actual clinical cases or fictional scenarios. Clinical practice and rationale for management decisions varied. Five themes were identified: (1) tension between patient autonomy and protecting a vulnerable person, (2) appropriateness of advance decisions for suicidal behaviour, (3) uncertainty about the application of legislation, (4) the length of time needed to consider all the evidence versus rapid decision-making for treatment and (5) importance of seeking support and sharing decision-making.
CONCLUSIONS: Advance decisions present particular challenges for clinicians when associated with suicidal behaviour. Recommendations for practice and supervision for clinicians may help to reduce the variation in clinical practice.
C’est la musique qui va sauver deux adolescents du naufrage psychologiqe où le suicide du petit ami de l’un et l’accident de voiture de l’autre, resté defiguré, les ont laissés…
A deux minutes près, leurs vies auraient pu ne jamais basculer…
Leur professeur de piano, ayant lui-même perdu un être cher, va les réunir pour une oeuvre à 4 mains de Shubert, et leur permettra de se reconstruire en s’étant apporté à chacun la part de lumière qu’ils pensaient à jamais perdue…
Bien écrit, réaliste, et boulversant de justesse sur les rapports complexes entre adolescents et adultes, quand le chagrin, le sentiment de culpabilité, la haine et le désespoir emportent tout sur leur passage.
Losing a loved one to suicide may have detrimental effects, one of them being suffering from complicated grief (CG). To date, no studies have fully examined the psychological processes that delineate the risk and resilience factors that contribute to CG among suicide-loss survivors (SLSs). We hypothesized that social support and self-disclosure would moderate the relationship between attachment styles and CG for SLS. Questionnaires assessing attachment style, self-disclosure, social support, and CG were completed by 156 SLS participants. A regression model revealed that secure attachment negatively predicted CG, but self-disclosure moderated this association. Secure attachment seems to be a resilient factor for CG. However, SLS with low secure attachment but high in self-disclosure ability use this behavior as a way to impede CG. The capacity to seek out other people, to share experiences with them, and to accept comfort from them may offer a means for SLS to better deal with their tragedy.
PURPOSE: Suicide bereavement confers unique risk and distress. In several countries, bereaved family members are called on to attend an inquest, an official public inquiry into deaths caused by external factors. The current study aimed to explore how suicide-bereaved family members (n = 18) experienced the inquest process, through qualitative semi-structured interviews.
METHOD: Participants were identified via coroner's records and had previously taken part in a case-control study.
RESULTS: Qualitative findings indicated four overall themes with respect to family members' experiences of the inquest process: "inquest as fearfully unknown", "structural processes of the inquest", "enduring public and private pain to obtain answers" and "gaining answers and making sense". Most family members experienced distress and fear as a result of several elements of the inquest process. Some participants had positive experiences but these did not outweigh the distress experienced by the majority of family members regarding their overall experience of the inquest process.
CONCLUSIONS: Key recommendations include informing family members of the main aspects and purpose of the inquest process beforehand, adapting the process to maximise the privacy and comfort of the bereaved relatives, and restricting graphic evidence being heard, where possible, to minimise distress experienced by family members.
Bereavement by suicide is a unique form of grief characterized by features such as stigma, shame, and rejection that may complicate the grieving process and place people at heightened risk for specific mental health disorders, suicide attempts, and dying by suicide. To better understand the unique support needs of the suicide-bereaved and how these can be met, this Australian study qualitatively explored the experiences of people bereaved by suicide. Fifteen individuals who had lost a spouse or partner or a family member to suicide formed three focus groups across different locations in Queensland, Australia. Analysis identified four dominant themes: changing support needs, difficulties navigating services, experiences of stigma and social isolation, and connecting with others. The results from this study provide a powerful insight into the experiences and specific needs of the suicide-bereaved and could inform further development of suicide bereavement support services.
BACKGROUND: Suicide bereavement is a risk factor for adverse outcomes related to grief, social functioning, mental health and suicidal behaviour. Consequently, suicide bereavement support (i.e., postvention) has been identified as an important suicide prevention strategy. However, little is known about its effectiveness. To redress this gap, this review aimed to assess the evidence of effectiveness of interventions for people bereaved by suicide, and appraise the quality of the research in this field.
METHODS: We conducted a systematic review according to PRISMA guidelines. Searches of peer-reviewed literature in Medline, PsycINFO, Embase and EBM Reviews identified 12 papers reporting on 11 relevant studies conducted between 1984 and 2018.
RESULTS: Across studies, there was a wide variety of intervention modalities, study populations, control groups, and grief, psychosocial and suicide-related outcome measures. Overall, the quality of studies was weak. While there was some evidence of the effectiveness of interventions for uncomplicated grief, evidence of the effectiveness of complicated grief interventions was lacking. Based on this scant evidence, interventions which seem to show promise include supportive, therapeutic and educational approaches, involve the social environment of the bereaved, and comprise a series of sessions led by trained facilitators.
CONCLUSIONS: There is a clear need for additional methodologically sound studies in this area. Specifically, selection procedures, sample sizes, randomization, and the use of appropriate measures are crucial. As people bereaved by suicide are at-risk of adverse grief, mental ill-health and suicidal behaviour, further research across the life-span is essential to prevent grief and mental health ramifications.
Trauma pathology is not only a sum of risk factors, but emerges as a result of complex causal interaction. The case presented here illustrates the pathway from suicide exposure to the development of fully-fledged treatment-resistant posttraumatic stress disorder (PTSD), demonstrating how recognized risk factors can act in tandem to generate a difficult to treat syndrome. From a clinical perspective, bottom-up approaches that take into account real coping experiences of people bereaved by suicide are more effective to facilitate recovery and prevent adverse outcomes. Finally, even though treatment is often implemented, the diagnosis can be missed further complicating coping and treatment.
As detailed in the lead article in this Special Issue, the Survivors of Suicide Loss Task Force of the National Action Alliance for Suicide Prevention in the United States has recently worked to formulate national guidelines to mitigate the harmful aftereffects of suicide in social and family systems. In the present article, we elaborate on one of four strategic directions addressed by the Task Force, namely, the development of goals and objectives for surveillance, research and evaluation of the impact of suicide loss. By emphasizing methodological guidelines for the conduct of future studies and illustrating progressive programs of investigation as leading exemplars, we hope to contribute to the sophistication of research on public health initiatives, peer support and professional intervention with communities, families and individuals affected by suicide loss.
This study aimed to develop a conceptual framework of the experience of persons who have lost a family member to suicide in Japan. The authors conducted in-depth interviews with 24 such family members. They conceptualized their experience as a process of regaining my new life. Initially, their lives were out of their hands, but gradually they learned striving skills and recuperative conditioning, and integrated the skills to regain their lives. Some participants eventually reached a state of living a redefined life. How individuals underwent this process varied. The authors identified two types of people dealing with this issue: dialoguers and mood changers.
Cet article présente, à l'aide de quelques positions célèbres, une vue d'ensemble de la réflexion sur le suicide dans l'histoire de la théologie chrétienne. Il abode notamment les positions d'Augustin, de Thomas d'Aquin, de Martin Luther et de Dietrich Bonhoeffer.
Dans les débats contemporains sur la fin de vie, l'euthanasie est une proposition majeure, à côté des soins pallaitifs et du suicide assisté. En analysant les valeurs qu'elle invoque - autonomie, liberté, dignité - l'article montre ses paradoxes et ses limitations et s'interroge sur les raisons de son succès.
Historiquement et étymologiquement, euthanasie n'est pas un mot grec classique. Les grecs avaient forgé un adverbe, un verbe puis un substantif qui signifiaient que la mort était douce ou belle, mais ils ne leur donnaient pas le même sens assez restrictif qu'on lui donne aujourd'hui, avec intervention d'un tiers. Pourtant, l'Antiquité a bien connu le suicide sous la forme d'une euthanasie. Puis une longue période interdit et condamne sans appel le suicide comme l'euthanasie et les religions juives, chrétiennes et musulmanes partagent toutes le respect absolu de la vie humaine, créée par Dieu. Il lui faut attendre le siècle des Lumières pour voir ressurgir le mot deuthanasie et le XIXe siècle pour que la médecine et les mentalités évoluent. Ce n'est qu'au XXe siècle que l'on osera enfin se (re)poser la question du libre choix de la mort pour la personne concernée ou pour son entourage quand elle ne peut plus s'exprimer, mais avec d'infinies précautions que seul le vocabulaire le plus explicite peut traduire. Aujourd'hui, les pays légifèrent, les uns après les autres, sur le sujet de l'euthanasie, le plus souvent sous la pression de l'opinion publique et des interrogations individuelles et sociologiques. Ainsi se fait jour la diversité des législations et des positions religieuses, pour la plupart inchangées depuis des siècles, mais qui témoignent toutes du caractère toujours infiniment délicat de l'euthanasie. Les êtres humains veulent bien mourir, mais de mort douce !
The impact of exposure to suicide death or attempt remains ill-understood. This article aims to investigate this impact among 3010 community residing Australian adults. An online survey investigated the burden of exposure to suicide, psychological distress, and predictors of distress. The following variables were most significant in predicting distress among those exposed to suicide death: perceived impact of the most impactful death, non-kin relationship to the deceased, number of close suicide attempt exposures, time since the most impactful death, and frequency of contact. Results demonstrate suicide is a highly impactful experience and this impact reaches well beyond kin.
Prolonged grief disorder (PGD), characterized by severe, persistent and disabling grief, is newly included in the International Classification of Diseases 11 (ICD-11). Receiving a PGD diagnosis could lead to stigmatizing public reactions (i.e. public stigma), yet research on this topic is limited. Additionally, while there is evidence that experiencing suicide bereavement causes public stigma, no studies to date have investigated the interaction between PGD and cause of death on public stigma. To fill these knowledge gaps, this experimental study tested if a PGD diagnosis (vs. no diagnosis) and experiencing suicide bereavement (vs. homicide and natural loss) cause public stigma. Three hundred and seventeen adults from the general population were randomly assigned to read one of 6 different vignettes of a person with and without PGD who had lost a spouse through a suicide, homicide or a stroke. After reading a vignette, negative attributions, emotional reactions, and desire for social distance were assessed. Notably, only persons with PGD were attributed relatively more negative characteristics, and elicited more anger, anxiety and pro-social emotions, and a larger preferred social distance in participants. This study supports the claim that PGD causes public stigma, but nuances claims that suicide bereavement induces public stigma.
Despite the high prevalence of suicide in gay communities, the impact of suicide on surviving male partners is poorly understood. This article presents a qualitative case study of two gay men who lost a partner to suicide and explores how stigma may shape gay men's bereavement experiences. Data were collected using photovoice methods and analysed using a thematic approach. Five themes were inductively derived: (1) trying to prevent the inevitable; (2) guilty of keeping secrets; (3) dreams shattered by suicide; (4) abandoned and alone in grief; and (5) a lonesome road to recovery. Within each theme, the article indentifies how stigma-related challenges associated with suicide, mental illness and minority sexual identity shaped gay men's bereavement experiences. Practice and policy implications are discussed, including how the provision of tailored clinical and peer supports can assist gay men in the bereavement of a same-sex partner to suicide. The findings detailed in this study highlight the need for interventions to de-stigmatise mental illness and suicide within and outside the gay community.
This study assessed the unique explanatory power of denial of disordered eating in understanding non-suicidal self-injury (NSSI) and suicidality. Undergraduate women (N = 360) completed an online survey about NSSI, suicide risk, disordered eating behaviors, and denial of disordered eating. Denial of disordered eating was associated with NSSI and suicidality above and beyond engagement in disordered eating alone and demographic covariates. This study provided support that denial of disordered eating behaviors assists in understanding risk for NSSI and suicidality. Campus programing might include psychoeducation about the negative consequences of denial and emphasize the importance of disclosure to trusted confidants.
OBJECTIVE: Childhood bereavement is linked to suicide-related behaviors in adolescence and adulthood, but candidate mechanisms through which bereavement may lead to suicide-related behaviors have not been explored. One candidate pathway is that grief reaction arising from bereavement lead to increased perceived burdensomeness and/or thwarted belongingness, resulting in increased suicide ideation. This cross-sectional study of bereaved adolescents explored indirect effects between grief reactions as distal predictors, perceived burdensomeness and thwarted belongingness as proximal predictors, and suicide ideation.
METHOD: Participants were 58 bereaved youth, 12â€“17 years of age (mean = 14.21, SD = 1.65; 81.0% female; 51.7% Hispanic, 17.2% African American, and 22.4% Caucasian), and their parents/guardians seeking services at a trauma and grief specialty outpatient clinic.
RESULTS: The indirect effect of grief reactions on suicide ideation via thwarted belongingness, but not perceived burdensomeness, was statistically significant.
CONCLUSIONS: Clinicians may wish to consider signs of thwarted belongingness as possible indicators of suicide risk among bereaved youth.
The present study aimed to validate a Korean version of the Interpersonal Needs Questionnaire in a college student sample. Three hundred and one students completed the scale and other measures of suicidal ideation, loneliness, interpersonal support, responsibility to family, meaning in life, fearlessness about death, anxiety and depression. Results revealed that the scale has two-factor structure (thwarted belongingness and perceived burdensomeness) and it also has good internal consistency, convergent validity and discriminant validity. Cultural comparisons showed that the levels of thwarted belongingness in Korean college students were higher than those in the U.S. college students.